Imaging of Spinal Cord Infections.

Primary infectious myelitis is a rare but critical diagnosis with potential for severe morbidity and permanent neurologic deficit if not detected and treated early. This article introduces an image-guided framework that organizes spinal cord infections into 5 distinct transverse magnetic resonance imaging patterns: extramedullary, centromedullary, eccentric tract-specific, frontal horn, and irregular or mass-like. This article recognizes the substantial variability in imaging manifestations of various infections in the spinal cord, and the proposed pattern-based approach is not intended to serve as a rigid diagnostic schema. Rather, it provides radiologists with a practical starting framework for evaluating acute infectious myelopathy.